Research project: Combining transcranial direct current stimulation (tDCS) with robotic hand training for the severely impaired hand after stroke

This can be done non-invasively using transcranial direct current stimulation (tDCS) Two electrodes are placed on the head; one over the motor cortex of the affected hemisphere and one over the contralateral orbit. A small direct current (1mA) is passed between them for a period of about 20 minutes during which the patient practices hand and arm exercises – in this study the exercises are performed in a robot. Changes in cortico-spinal excitability can be measured as well as motor function – measured by performance in the robot games. tDCS is painless – it cannot be felt after the first few seconds. 

While most patients regain walking ability, a severe upper limb paresis with no voluntary hand and finger activity, affecting a third of people after stroke, has a poor prognosis' Transcranial direct current stimulation (tDCS) is a non-invasive procedure used to polarise brain regions through the application of weak direct currents and has the potential to develop into useful adjuvant strategies in neurorehabilitation. Recent literature into the application of tDCS in people with severe arm impairments after stroke is increasing and has shown promising results.

The aim of this study is to examine the effect of combining transcranial direct current stimulation with robotic hand and arm training for the impaired hand and arm after stroke. Transcranial magnetic stimulation (TMS) will be used to measure short and long-term changes in cortico-motor excitability. Anodal tDCS will be applied to the primary motor cortex of the affected hemisphere. The cathode will be positioned on the contralateral supraorbital region. tDCS (1 mA) will be applied for 20 min in the tDCS session and up to 30 sec in the Sham session. Ramps will be used to increase and decrease current.

Project team

Professor Jane Burridge, Dr Geert Verheyden Hochschule für Gesundheit – University of Applied Sciences, Bochum, Germany

Dr Ann-Marie Hughes (Senior Research Fellow)

Prof John Rothwell Professor (University College London) Professor of Human Neurophysiology, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK

Lisa Tedesco Triccas (PhD Studentship)

Project funder

Wessex Medical Research